title: Psychomotor approach in children affected by nonretentive fecal soiling (FNRFS): a new rehabilitative purpose.
abstract: BACKGROUND
  According to the Rome III criteria, encopresis without constipation was defined as nonretentive fecal soiling (FNRFS) with not yet well understood etiology. Treatment approaches reported in the literature with varying results include biofeedback, hypnosis, reflexology, and Internet-based educational programs. In developmental age, another behavioral treatment could be identified in the psychomotor approach, which is called psychomotricity in the European countries, or is also known as play therapy. The aim of the present study was to verify the safety and efficacy of play therapy plus toilet training in a small sample of prepubertal children affected by FNRFS.
  
  
  METHODS
  Twenty-six patients (group 1; 16 males, mean age of 5.92 ± 0.84 years) underwent a psychomotor approach therapy program in association with toilet training for 6 months, and the other 26 subjects (group 2; 17 males, mean age of 5.76 ± 0.69) underwent the sole toilet training program for 6 months. During the observational time period (T0) and after 6 months (T1) of both treatments, the patients were evaluated for FNRFS frequency and for the behavioral assessment.
  
  
  RESULTS
  At T0, the FNRFS mean frequency per month for group 1 was 20.115 episodes/month (standard deviation [SD] ± 3.024) and for group 2 was 20.423 (SD ± 1.879) (P = 0.661). At T1 the mean frequency per month was 6.461 (SD ± 1.333) episodes/month and 12.038 (SD ± 1.341), respectively (P < 0.001). Moreover, the delta percent average of the frequency between T0 and T1 was 67.121 ± 8.527 for group 1 and 40.518 ± 9.259 for group 2 (P < 0.001). At T1, a significant improvement in scores on the behavioral scale was identified.
  
  
  CONCLUSIONS
  Our preliminary results show the importance of a multidisciplinary approach, and suggest the positive effect of an additional psychomotor approach, as this holds a new and interesting rehabilitative purpose for children in a toilet training program, even if further research is necessary.
authors.affiliation: Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Esposito
authors.forename: Francesca
authors.initials: F
authors.lastname: Gimigliano
authors.forename: Maria
authors.initials: M
authors.lastname: Ruberto
authors.forename: Rosa
authors.initials: R
authors.lastname: Marotta
authors.forename: Beatrice
authors.initials: B
authors.lastname: Gallai
authors.forename: Lucia
authors.initials: L
authors.lastname: Parisi
authors.forename: Serena Marianna
authors.initials: SM
authors.lastname: Lavano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mazzotta
authors.forename: Michele
authors.initials: M
authors.lastname: Roccella
authors.forename: Marco
authors.initials: M
authors.lastname: Carotenuto
keywords: children; encopresis; psychomotricity; rehabilitation; toilet training